BACKGROUND AND PURPOSE Carcinoembryonic antigen (CEA) is used as a tumour marker in breast cancer (BC). In order to assess diagnostic value of CEA in BC we examined its serum levels and frequencies of its increase in breast cancer patients (BCP), and compared them to those in controls. We also determined CEA in patients with metastatic and non-metastatic BC, and calculated sensitivity and specificity of CEA in BC. PATIENTS AND METHODS The main experimental group consisted of 47 female patients with histologically proved diagnosis of BC. There were two control groups: clinically healthy women, and female patients with other locations of cancer. Circulating levels of CEA were measured by means of immunoradiometric assay. Results were processed by means of t-test and two-way analysis of variance. RESULTS Circulating levels of CEA, before treatment in BCP, were significantly higher (p<0.0001) than in healthy women, and in patients with other cancers (p<0.007), while serum CEA in other cancer patients was significantly higher (p<0.01) than in healthy control. There was a difference between frequencies of CEA increase in BCP and healthy women, while such a difference did not exist between BCP and other cancer patients. The circulating levels of CEA in metastatic BCP were significantly higher (p<0.03) in comparison to non-metastatic patients. Sensitivity and specificity of CEA in BCP was 65.0%, and 57.1%, respectively. CONCLUSIONS CEA does not have high tumour specificity for BC, since its circulating levels as well as frequencies of its increase may be elevated in patients with other types and locations of cancer, different from breast cancer. CEA can be detected in the serum of majority of patients with metastatic BC. CEA may be used as prognostic tumour marker in advanced BC.

“We think that science has already explained all when explained movement of the Moon around the Earth. But the real world is not universe like a simple pendulum clock.”Jim York, a physicist from the University of Maryland who coined the name “chaos”We are assured that the field of “Human Cloning” comprise the most crucial scientific questions of present time. It seems that all exaltation of its progress and fascinating results have vanished while being replaced with the cogitative concern that Immanuel Kant expressed in three fundamental questions:What can I know?What should I do?What may I hope?While considering all these questions famous philosopher thought about any human being.Today, these queries consideration is based on the experience of illuminator “ingress” in all that exist, as well as in the human being itself. Experience of the “illumination” triumph seduces science beyond its achievements and freedoms. We would say that science wants even beyond its real wants. Nowadays, global scientific impact appears as general opinions correlated to the universe of technological utilisation, professionalism in knowledge and biological science influence on the behavioural inducements.The basic thinking principles established by modern science are inseparable from the statements of philosopher Descartes: “World of mind and world of body are separated as individual substances that exist separately without any needful co-existence”. In that way, a new authoritative scientific relation towards the world has been created, out of which, the field of values “Heavens are devoid of the glory of God” (A.N. Whitehead, “Science and the modern world”) has been completely excluded or eliminated.It is obvious that the crucial postulations of nature are created throughout gathering of the sufficient data and simplification of the numerous correlative causes and consequences in other to elucidate “the anarchy of systems” and accomplish the exact predictions of their attitudes. Amazing technological progress in 20th century made many people believe that some day science would find out all ignorance of nature and improve the control over it. According to that assumption, the attitude of very complex dynamic systems would finally conform to the scientific formulations and calculations.A fascinating thoughtful help of chaosologists, particularly in their theory of fractals that revealed an apprehension of the reality as made from worlds within self-similar worlds i.e. worlds within dimensions, is necessary for the proper quantification of defect associated with the progress in knowledge of life. That knowledge has been previously neglected to the simple scientific facts and responsibilities (especially in medicine) that naturally appear from inside when life is recognised as a holistic system.

Posttraumatic stress disorder (PTSD) is a psychiatric disorder characterised by an acute emotional response to a traumatic event or situation involving severe environmental stress (natural disasters, wars, epidemics, rape, assaults, physical torture, catastrophic illness or accident), which may be identified in cognitive, affective or sensory motor activities. The objective was to perform a pilot clinical trial designed to compare the effects of older (tricyclic) and newer "second-generation" (selective inhibitors of serotonin uptake) antidepressants in the treatment of PTSD. A total of 20 hospitalised chronic military combat Bosnian veterans with PTSD symptoms were randomly assigned into two groups of 10 patients each. One group was treated with amitriptyline hydrochloride (AMYZOL) 75 mg/day as a representative of older antidepressants and the other with fluoxetine hydrochloride 60 mg/day (OXETIN) as a representative of newer antidepressants. Those drugs were administered by mouth two or three times-a-day in equally divided doses for at least 8 weeks. Favourable response was achieved in 70% of patients treated with amitriptyline hydrochloride and 60% of patients treated with fluoxetine hydrochloride. Amitriptyline hydrochloride was more effective in the treatment of acute PTSD symptoms (emotional numbing, startle reaction, nightmares, flashbacks, intrusive thoughts, vulnerability, poor impulse control or irritability and explosiveness). Fluoxetine hydrochloride showed a greater efficacy in the treatment of chronic PTSD symptoms (avoidance and numbing symptoms, hyperarousal, nightmares and a feeling of guilt).

Acute lumbar syndrome occurs suddenly and is accompanied with strong pain in the lower part of the back. The most frequent APLS causes are vertebral (herniation of intervertebral disc, subluxation of intervertebral disc, subluxation of intervertebral joint, fracture of vertebra--traumatic or pathological), or extravertebral (subluxation of sacroiliac joint, acute bursitis of iliolumbar segment, muscle injuries or injuries of tendo-ligamentous apparatus of lumbosacral region). The treatment of acute lumbar painful syndrome is classified as medical, alternatively medical, surgical and combined. On the basis of durable experience, "Praxis method" as a treatment of lumbar pain (general and acute) is being applied in the Centre for Physical Medicine and Rehabilitation "Praxis" in Sarajevo. During the period from 1996 to 2000, the total number of 5.663 patients were examined in the centre "Praxis". Out of that number, 17.7% (1.003) of patients had acute lumbar painful syndrome (ALPS). Immediately after the therapeutic manipulation, which included "Praxis method, 31.5% (317) patients experienced the cessation of pains followed by ending of the treatment. The length of treatment for the rest of patients lasted: 1-7 days in 412 or 41.07 % of patients, 8-21 days in 195 or 19.48% of patients, and more than 21 days in 79 or 7.88% of patients. For all patients (1.003) the average treatment duration was 6.6 days. The recidivation occurred in 127 patients (12.66%). Throughout the treatment successfulness estimation according to clinical results scaled from 0 to 5, it was confirmed that out of the total number of 831 patients (82.85%) results were excellent in 459 patients (45.76%) or very good in 372 patients (35.09%). The average age of patients was ranging between 35 and 45 years (621 patients or 61.9%). The male/female distribution was 2:1.

Defining exact position of weak anatomic function which is find in a base of neurological and psychiatric disorder is just became the subject of intensive research interest. For this purposes it is important to implement structural and functional MRI techniques, also for further lightening and seeing subject of this work, more concretely connected to PTSD. Therefore, exactly MRI gives most sensitive volumetric measuring of hippocampal formation and amygdaloidal complex. The goal of this work was to research asymmetry of hippocampal formation and amygdaloidal complex to the PTSD patients. Results showed that at the axial slice length of hippocampal formation on the left and right side of all patients are significantly asymmetric. At the sagittal slice from the left side of hippocampal formation is in many cases longer than right about 50 %. At the coronal slice, there are no significant differences toward patient proportion according to symm./asymm. of the hippocampal formation width at the right and left side. Difference in volume average of hippocampal formation between right and left side for axial and coronal slice is not statistically significant, but it is significant for sagittal slice. In about amygdaloidal complex patients with PTSD toward symm./asymm. Amygdaloidal complex at the right and left side of axial and sagittal slice in all three measurement shows asymmetry, what is especially shown at sagittal slice. Difference in average length of amygdaloidal complex at the right and left side is not statistically significant for no one slice. Therefore, results of a new research that are used MRI, showed smaller hippocampal level at PTSD (researched by Van der Kolka 1996, Pitman 1996, Bremner et al., 1995.). Application of MRI technique in research of asymmetry of hippocampal formation and amygdaloidal complex, which we used in our research, we recommend as a template for future researches in a sense of lightening anatomic function that is a base of neuropsychiatric disorders.

Research on the parameters of full blood count and differential white blood count is included in the program of all medical laboratories of primary, secondary and tertiary health care levels. Today, all haematological tests are exclusively performed on the haematology analyzers. Automation of haematology laboratories is a result of the huge requires for haematological test performing, timely issuing of the haematological findings, and possibility of the usage of modern techniques. This work is an evaluation of laser haematology analyzer Cell-Dyn 3700 SL. It investigates the reliability of test results throughout the following parameters: precision, accuracy, sensitivity and specificity of determination methods. It also explores the influence of sample transferring and correlation with haematology analyzer MAXM Retti. Haematology parameters that have been investigated are: white blood cell (WBC), neutrophils (NEU), lymphocytes (LXM), monocytes (MONO), eosinophils (EOS), basophils (BASO), red blood cells (RBC), haemoglobin (HGB), haematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCHC) red cell distribution width (RDW), platelet (PLT), mean platelet volume (MPV), plateletocrit (PCT), and platelet distribution width (PDW). The results confirms that precision of analyzer fulfils the reproducibility of testing parameters: WBC, RBC, HGB, MCV, MCH, MCHC, and PLT. Correlation coefficient values (r) gained throughout the statistical analysis, that is linear regression results obtained throughout the comparison of two analyzers are adequate except for MCHC (r = 0.64), what is in accordance with literature data. Accuracy is tested by haematology analyzer method and microscopic differentiating method. Correlation coefficient results for granulocytes, lymphocytes and monocytes point the accuracy of methods. Sensitivity and specificity parameters fulfil the analytical criteria. It is confirmed that haematology analyzer Cell-Dyn 3700 SL is reliable for the determination of full blood count in everyday work. Analyzer and its program for differential white blood count can be used for the research and separation of normal and pathological blood counts with addition of microscopic methods confirming distribution or morphologic changes of leukocytes.

Medical devices and medical disposables contribute significantly to the quality and effectiveness of the health care system. It is necessary to commit scientifically sound regulatory environment that will provide consumers with the best medical care. This includes continued services to small manufacturers, readily available guidance on FDA requirements, predictable and reasonable response times on applications for marketing, and equitable enforcement. But in the public interest, this commitment to the industry must be coupled with a reciprocal commitment: that medical device firms will meet high standards in the design, manufacture, and evaluation of their products. The protections afforded our consumer, and the benefits provided the medical device industry, cannot be underestimated.

The purpose of this study has been evaluation our possibilities of diagnostic and treatment children with congenital heart disease. We were analyzing medical documentation from 352 children with discovered congenital heart disease in period of six years in Tuzla Canton area. disease. The average age at diagnosis was 2,15±2,28 years. During first cardiac examination 51,98% children presented symptoms of cardiac disease. Growth retardation in postnatal period is noticed in 13,35%. Electrocardiographic changes are registered in 47,76%, while changed chest radiogram in 53,85% of patients. Medicament treatment was needed in 20,74% and cardiovascular surgery procedure in 40,60%. Urgent surgery treatment was needed in 62 patients with critical heart disease. Cardiovascular surgery was made in 23,29% of patients, and average age was 4,81±3,23 years. Mortality of children with congenital heart disease is relatively high and it is 19,60%, the biggest number of them (95,65%) died before and only 4,35% after cardiosurgical treatment. Average age of children who died was 0,51±0,59 year. Considering clinical indicators of congenital heart disease in Tuzla Canton area, it is evidenced that this children health problem, which due difficult clinical picture, big involvement in infant mortality, growth retardation with progression in chronic cardiopathy, require urgent measures with main goal on advanced organizing of its diagnostic and treatment.

The problem of the lack of good quality and quantity of water for all purposes has been increasing due to the war damage to water supply plants, the effects of the unique phenomena of subsidence of the area as well as flooding caused by recent heavy rain in the area of Tuzla Canton. The flood has resulted in pollution of the drinking water and, in the light of this emergency we carried out a study to determine drinking water quality by two methods: traditional tests required by law and specific laboratory tests. The aims of the microbiological analysis of water were: to detect evidence of excretal biological pollution as a result of the flooding in the area of Tuzla Canton in 2002; to evaluate the required laboratorial procedures in Bosnia and Herzegovina for the detection of potent pathogens in the drinking water. The study included the examination of 99 samples of water: 48 samples from municipal water supplies; 13 from closed sources and 38 from open sources. Samples of water were tested by routine bacteriological, parasitological and biological methods. Reverse transcription -polymerase chain reaction (RT-PCR) was applied for the detection of viruses. Microorganisms were absent in four (4.04%) of the 99 samples of water. Out of 95 samples of water, 240 micro-organisms were isolated as follows: 114 strains of bacteria, 56 viruses, 52 bacteriophages (19 coliphages and 33 Salmonella enteritidis phage), 2 nematodes, 16 algae. According to traditional tests required by law, water from 35.35% (35/99) sources was found suitable for drinking but using specific laboratory tests, only 10.10% (10/99) of samples were in compliance with the law. There was a significant difference in water quality (p<0.01). These results call for a revision of water quality guidelines based only on indicator organisms without also making reference to the absence of viruses. We have pointed out the importance of all the parameters, which should be applied during emergencies such as the recent flooding. We also suggest that, along with routine examination of drinking water there should be periodically (per month or per year) incorporated into the current protocol extra measures for detection of enteroviruses and bacteriophages.

Numerous locations of Osteoid-osteoma are described in our pervious literature. This benign tumor is followed by strong night pains, which are making more difficult life for the patients. It still presents a big challenge for surgeon. This case report has intention to show ectopic intraarticular location in elbow with consecutive synovial reaction.